Drug treatment

Drug treatment of Orthostatic hypotension

Volume expanders:

Fludrocortisone – low dose, starting with 50 mcg note increasing the dose gradually every six weeks to a maximum of 200 mcg or 300 mcg note if required

Flurbiprofen – a Non Steriodal Anti Inflammatory Drug may be used in conjunction with Fludrocortisone to enhance fluid retention

Adrenoreceptor agonists:

Midodrine – post-ganglionic alpha agonist. Named patient basis, only, in UK
Ephedrine – beta agonist. Use with care tds with last dose early evening

Specific targeting:

Octreotide – for post-prandial hypotension

Desmopressin – with Fludrocortisone if nocturnal polyuria

Erythropoietin – for refractory anaemia in renal failure